| Banyan Group | |
|
3898 Via Poinciana Suite 13 Lake Worth FL 33467-2951 | |
| (561) 967-2566 | |
| (561) 967-4556 |
| Full Name | Banyan Group |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 3898 Via Poinciana, Lake Worth, Florida |
| Authorized Official Name and Position | Richerd Whittemore (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5619672566 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Banyan Group 3898 Via Poinciana Suite 13 Lake Worth FL 33467-2951 Ph: (561) 967-2566 | Banyan Group 3898 Via Poinciana Suite 13 Lake Worth FL 33467-2951 Ph: (561) 967-2566 |
| NPI Number | 1831295559 |
|---|---|
| Provider Enumeration Date | 09/16/2006 |
| Last Update Date | 07/20/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831295559 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | SW001957 (Florida) | Primary |
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